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PURPOSE: Neurodevelopmental disorders, such as autism spectrum disorder (ASD), have been increasingly associated with eosinophilic gastrointestinal disorders (EGID). However, the relationship between these diseases remains unclear. We performed a systematic review with meta-analysis to address this issue. METHODS: The search was performed according to the PRISMA guidelines using descriptors for ASD and EGIDs from the MEDLINE, Embase, PsycInfo, LILACS, and Web of Science databases. Observational studies with the prevalence of ASD in any EGID were included. The study protocol was registered on the PROSPERO platform under the number CRD42023455177. RESULTS: The total dataset comprised 766,082 participants. The result of the single-arm meta-analysis showed an overall prevalence of ASD in the population with EGID of 21.59% (95% CI: 10.73-38.67). There was an association between EGID and ASD (OR: 3.44; 95% CI: 1.25-2.21), also significant when restricted only to EoE (OR: 3.70; 95% CI: 2.71-5.70). DISCUSSION: Recent studies have implicated the influence of an inadequate epithelial barrier integrity in the pathogenesis of several diseases. The role of this mechanism can be extended to situations beyond allergic reactions, including other conditions with underlying immunological mechanisms. Several diseases are potentially related to the systemic effect of bacterial translocation in tissues with defective epithelial barriers. CONCLUSION: Our meta-analysis provides evidence that supports the consideration of EGID in patients with ASD and ASD in patients with EGID. Despite its limitations, the results should also be validated by future studies, preferably using multicenter prospective designs in populations with low referral bias.

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INTRODUCTION AND AIMS: Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders. Prevalence worldwide is estimated at 11%. There is little information on the prevalence of the other functional bowel disorders (FBDs). Our aim was to establish the prevalence of IBS and other FBDs according to the Rome IV criteria, in Uruguay. MATERIALS AND METHODS: An observational, population-based prevalence study was conducted. Data were collected through an online questionnaire, utilizing the Rome IV criteria. RESULTS: Of the 1,052 participants (79% women, mean patient age 44 years), 47.2% met the Rome IV diagnostic criteria for at least one of the FBDs analyzed. Functional constipation (FC) was the most frequent, at 18.7% (16.4-21.1), followed by IBS at 17.1% (14.9-19.4) and functional diarrhea (FD) at 15.4% (13.3-17.6). IBS with constipation (IBS-C) was the most frequent IBS subtype (35%) and the IBS with diarrhea (IBS-D) subtype predominated in men. All FBDs were more prevalent in women and youths. Of the survey participants with a FBD, 59% stated that they perceived no worsening of their symptoms related to the COVID-19 pandemic. CONCLUSIONS: Ours is the first prevalence study on FBDs conducted on the Uruguayan general population. Half of the participants surveyed presented with a FBD analyzed in the study. FC was the most frequent, followed by IBS and FD. The prevalence rate of IBS was the highest, based on the Rome IV diagnostic criteria, and constipation was the most frequent subtype.

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The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariat-ric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article compre-hensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern ex-ists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongo-ing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to sup-port its routine use in clinical practice.

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BACKGROUND: Psychosocial and physical trauma are known risk factors for irritable bowel syndrome (IBS), including in war veterans, whereas war exposure in civilians is unclear. Nicaragua experienced two wars, 1970-1990: The Sandinistas Revolution (1970s) and The Contra War (1980s). Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system (11000 households). AIM: To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua. METHODS: We conducted a nested population-based, cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria. 1617 adults were randomly selected. The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua. War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects. Multiple exposures were defined by ≥ 3 measures. RESULTS: The prevalence of IBS was 15.2% [Female (F) 17.1%, Male (M) 12.0%], war exposure 19.3% (F 9.3%, M 36.7%), and post-traumatic stress disorder (PTSD) 5.6% (F 6.4%, M 4.3%). Significant associations with IBS in the civilian population were observed (adjusted by gender, age, socioeconomic status, education): physical and psychological abuse [adjusted odds ratio (aOR): 2.25; 95% confidence interval: 1.1-4.5], witnessed execution (aOR: 2.4; 1.1-5.2), family member death (aOR: 2.2; 1.2-4.2), and multiple exposures (aOR: 2.7; 1.4-5.1). PTSD was independently associated with IBS (aOR: 2.6; 1.2-5.7). CONCLUSION: An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS. Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.

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This review focuses on plant species traditionally used in Rio Grande do Sul, Santa Catarina and Paraná states (southern Brazil) for the relief of digestive disorders. Fifty ethnobotanical studies were compiled, resulting in 384 species mentioned, of which those cited in common to every state were selected. The search retrieved 63 native species used to alleviate gastrointestinal disorders, distributed in 21 botanical fa milies, mainly Asteraceae, Lamiaceae and Myrtaceae. The most cited species include Achyrocline satureioides (82%), Eugenia uniflora (70%), Baccharis crispa (46%), Psidium cattleyanum (36%), Solanum paniculatum (36%) and Monteverdia ilicifolia (34%). Scient ific studies have corroborated their popular use for the relief the gastrointestinal disorders, but most of them are preclinical and mainly exploratory. In conclusion, the folk use of medicinal species with therapeutic purposes is widespread in southern Br azil, but further studies are needed to guarantee their efficacy and safety.

Esta revisión presenta especies de plantas utilizadas en Rio Gra nde do Sul, Santa Catarina y Paraná (Sur de Brasil) con enfoque en el alivio de los trastornos digestivos. Se recopilaron 50 estudios etnobotánicos en los que se mencionaron un total de 384 especies, siendo seleccionadas las especies en común a todos los e stados. La búsqueda recuperó 63 especies nativas citadas como utilizadas para aliviar trastornos gastrointestinales, distribuidas en 21 familias botánicas, principalmente Asteraceae, Lamiaceae y Myrtaceae. Las especies con mayor frecuencia de citación fuer on: Achyrocline satureioides (82%), Eugenia uniflora (70%), Baccharis crispa (46%), Psidium cattleyanum (36%), Solanum paniculatum (36%) y Monteverdia ilicifolia (34%). Los estudios científicos han corroborado el uso de especies para el alivio de los trast ornos gastrointestinales, pero la mayoría de ellos son preclínicos y principalmente exploratorios. En conclusión, el uso popular de especies medicinales con fines digestivos está muy extendido en el sur de Brasil, pero aún se necesitan estudios científicos para garantizar la eficacia y seguridad de estas plantas.

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Clostridioides difficile infections (CDI) have a high morbidity and mortality rate and have always been considered a nosocomial disease. Nonetheless, the number of cases of community-acquired CDI is increasing, and new evidence suggests additional C. difficile reservoirs exist. Pathogenic C. difficile strains have been found in livestock, domestic animals, and meat, so a zoonotic transmission has been proposed. OBJECTIVE: The goal of this study was to isolate C. difficile strains in dogs at a veterinary clinic in Rio de Janeiro, Brazil, and characterize clinical and pathological findings associated with lower gastrointestinal tract disorders. METHODS: Fifty stool samples and biopsy fragments from dogs were obtained and cultured in the CDBA selective medium. All suggestive C. difficile colonies were confirmed by MALDI-TOF MS and PCR (tpi gene). Vancomycin, metronidazole, moxifloxacin, erythromycin, and rifampicin were tested for antibiotic susceptibility. Biofilm, motility assays, and a PCR for the toxins (tcdA, tcdB, and cdtB), as well as ribotyping, were also performed. RESULTS: Blood samples and colonic biopsy fragments were examined in C. difficile positive dogs. Ten animals (20%) tested positive for C. difficile by using stool samples, but not from biopsy fragments. Most C. difficile strains were toxigenic: six were A+B+ belonging to RT106; two were A+B+ belonging to RT014/020; and two were A-B- belonging to RT010. All strains were biofilm producers. In the motility test, 40% of strains were as motile as the positive control, CD630 (RT012). In the disc diffusion test, two strains (RT010) were resistant to erythromycin and metronidazole; and another to metronidazole (RT014/020). In terms of C. difficile clinicopathological correlations, no statistically significant morphological changes, such as pseudomembranous and "volcano" lesions, were observed. Regarding hematological data, dogs positive for C. difficile had leucopenia (p = 0.02) and lymphopenia (p = 0.03). There was a significant correlation between senility and the presence of C. difficile in the dogs studied (p = 0,02). CONCLUSIONS: Although C. difficile has not been linked to canine diarrheal disorders, it appears to be more common in dogs with intestinal dysfunctions. The isolation of ribotypes frequently involved in human CDI outbreaks around the world supports the theory of C. difficile zoonotic transmission.

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Gastroesophageal reflux disease (GERD) is a clinical condition in which gastric reflux causes symptoms or damage to the esophageal mucosa. It is managed with proton pump inhibitors, however, up to 45% of patients with suspected GERD are refractory to treatment. It is necessary to establish a true GERD diagnosis by means of a digestive endoscopy, which does not show lesions in approximately 70% of patients. In this scenario, it is necessary to perform an esophageal pH-impedance measurement, a procedure that allows to determine whether exposure to gastric acid is pathological. Of this group, patients with pathological acid exposure are diagnosed as true non-erosive reflux disease (NERD). If, in addition to not presenting esophageal lesions, they have a physiological exposure to gastric acid, they suffer from esophageal hypersensitivity or functional heartburn, which are functional disorders. These require a different approach from that of GERD or NERD, as the symptoms are not due to pathological exposure to gastric acid. The aim was to calculate the frequency of esophageal hypersensitivity and functional heartburn in patients with suspected NERD. This was a cross-sectional study. Data was collected by reviewing pH-impedance and manometry reports, 166 patients were selected. The frequency for functional disorders was 86.15%, being 46.9% for functional heartburn and 39.2% for esophageal hypersensitivity. The frequency of functional disorders was higher than that reported in previous studies. In conclusion, age, psychological conditions, dietary, cultural, ethnic or lifestyle factors inherent to our environment might play important roles in the development of functional disorders.

La enfermedad por reflujo gastroesofágico (ERGE) es una condición clínica en la que el reflujo gástrico provoca síntomas o daños en la mucosa esofágica. Se maneja con inhibidores de la bomba de protones; sin embargo, hasta el 45% de los pacientes con sospecha de ERGE son refractarios al tratamiento. Por lo cual, es necesario establecer un verdadero diagnóstico de ERGE mediante una endoscopia digestiva, que no muestra lesiones en aproximadamente el 70% de los pacientes. En este escenario, es necesario realizar una medición de pH-impedancia esofágica, procedimiento que permite determinar si la exposición al ácido gástrico es patológica. De este grupo, los pacientes con exposición patológica al ácido son diagnosticados como verdadera enfermedad por reflujo no erosiva (ERNE). Si además de no presentar lesiones esofágicas, tienen una exposición fisiológica al ácido gástrico, padecen hipersensibilidad esofágica o pirosis funcional, que son trastornos funcionales. Estos requieren un enfoque diferente al ERGE o ERNE, ya que los síntomas no se deben a una exposición patológica al ácido gástrico. El objetivo fue calcular la frecuencia de hipersensibilidad esofágica y pirosis funcional en pacientes con sospecha de ERNE. Este fue un estudio transversal. Los datos se recopilaron mediante la revisión de informes de pH-impedancia y manometría, se seleccionaron 166 pacientes. La frecuencia de trastornos funcionales fue de 86,15%, siendo 46,9% de pirosis funcional y 39,2% de hipersensibilidad esofágica. La frecuencia de trastornos funcionales fue superior a la reportada en estudios previos. En conclusión, la edad, las condiciones psicológicas, los factores dietéticos, culturales, étnicos o de estilo de vida inherentes a nuestro entorno podrían jugar un papel importante en el desarrollo de trastornos funcionales.

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OBJECTIVE: To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children. METHODS: A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese. RESULTS: FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p  = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02). CONCLUSION: Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

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Resumen Los trastornos gastrointestinales funcionales (TGF) son enfermedades crónicas que configuran un problema relevante en la salud pública, asociados en investigaciones previas a una peor calidad de vida. El objetivo del presente trabajo fue estudiar la calidad de vida en pacientes que acuden a un servicio de neurogastroenterología en un hospital de Argentina y compararlo con población control. Para ello, se realizó un estudio cuantitativo y transversal incluyendo población clínica diagnosticada con algún TGF (n = 35) y una muestra control sin diagnóstico de TGF (n = 37). Se encontraron diferencias significativas entre personas con TGF y sujetos control, X 2 (1, N = 70) = 30.23,p < .001 en todas las subdimensiones de la escala de calidad de vida (MQLI), exceptuando satisfacción espiritual (PE). Similar a investigaciones previas, los resultados de este estudio sugieren que, en Argentina -al igual que en otros países-, los individuos con TGF muestran una peor percepción de calidad de vida que la población general. Estos hallazgos podrían contribuir al diseño de intervenciones que contemplen variables biopsicosociales, con el objetivo de una mejoría integral en la calidad de vida de las personas que padecen estos trastornos.

Abstract Functional Gastrointestinal Disorders (FGDS) are chronic diseases that constitute a relevant public health problem, associated in previous research with a poorer quality of life. The aim of this study was to study the quality of life in patients attending a Neurogastroenterology Service at an Argentinean public hospital and compare it with a control population. A quantitative and cross-sectional study was carried out including a clinical population diagnosed with some FGD (n = 35) and a control sample without diagnosis of FGD (n = 37). Significant differences were found between people with FGD and control subjects, X 2 (1, N = 70) = 30.23, p < .001 in all sub-dimensions of the Quality of Life Index (MQLI), except Spiritual Fulfillment (SF). Similar to previous research, the results of this study suggest that individuals with FGD show a worse perception of quality of life than the general population. These findings could contribute to the design of interventions that contemplate biopsychosocial variables, with the aim of a comprehensive improvement in the quality of life of people with these disorders.

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Within the broad range of therapeutic options for managing functional gastrointestinal disorders, recently redefined as Disorders of Gut-Brain Interaction (DGBI) by the Rome Foundation in the Rome IV criteria, certain medications with antidepressant, anxiolytic, or antipsychotic effects are commonly employed. These drugs, now referred to as neuromodulators by the Rome Foundation, target the neurogastroenterological dysfunction associated with these disorders. Consequently, their clinical utility as psychiatric medications can now be leveraged to benefit patients with DGBI. This narrative review aims to provide an updated and specific overview of the indications for neuromodulators in the primary DGBI. The first section of this review focuses on the rationale and justification for their use.

En el amplio espectro de las opciones terapéuticas para el manejo de los trastornos funcionales digestivos, que se han redefinido por la Fundación Roma en los criterios Roma IV como trastornos de la interacción cerebro-intestino (TICI), algunos medicamentos con efectos antidepresivos, ansiolíticos o antipsicóticos se utilizan con mayor frecuencia. Estos medicamentos, que actúan en la disfunción neurogastroenterológica de estos trastornos, también han sido renombrados por la Fundación Roma como neuromoduladores, para que ahora puedan aprovecharse sus beneficios terapéuticos en este ámbito clínico, debido a su utilización como medicamentos psiquiátricos. Esta revisión narrativa tiene por objeto actualizar y precisar las indicaciones de los neuromoduladores en los principales TICI, y en esta primera sección se aborda la racionalidad y justificación para su utilización.

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INTRODUCTION AND AIMS: Any alarm symptoms in patients with irritable bowel syndrome (IBS) should be carefully evaluated. Colonoscopy is a standard diagnostic procedure for evaluating the colonic mucosa and ruling out probable diseases responsible for patient symptoms. We analyzed the colonoscopy findings in patients with and without IBS. MATERIAL AND METHODS: Ninety-six patients with IBS and 101 without IBS were consecutively enrolled in the study. All the patients in the IBS group met the Rome IV criteria, and underwent colonoscopy due to the appearance of red flags. The colonoscopy findings were compared between the 2 groups of patients. RESULTS: The main indications for colonoscopy in the IBS group were progressive abdominal pain (36.7%), rectal bleeding with fresh blood (17.7%), and occult blood in stool (12.5%). In the non-IBS group, the most prevalent indicators were rectal bleeding with fresh blood (37.6%), colorectal cancer surveillance (21.8%), and abdominal pain (13.9%). The most common macroscopic findings in the 2 groups were hemorrhoids, polyps, and anal fissure. There were no statistically significant differences with respect to the microscopic and macroscopic findings between groups. CONCLUSIONS: We concluded that the prevalence of organic lesions in the colon of patients with IBS was the same as that in the patients without IBS. The Rome IV criteria accurately predicted IBS. Additional evaluation through colonoscopy in IBS should be based on the presence of alarm features.

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Abstract Objective: To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children. Methods: A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese. Results: FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02). Conclusion: Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

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Purpose: We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs). Methods: This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS). Results: Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with Helicobacter pylori (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (p>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (p<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (p<0.02), although poor school performance (p<0.0007) and bullying (p<0.01) were higher in patients with ORGD. Conclusion: This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.

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A pandemia de COVID-19 se propagou rapidamente pelo mundo, causada pela infecção do novo coronavírus (SARS-CoV-2), que surgiu na China no final de 2019. Apesar da porta de entrada mais comum do agente etiológico ser pelo trato respiratório, evidências demonstram que a doença pode apresentar sintomas extrapulmonares, como os do trato gastrointestinal. Descrever sobre possíveis alterações gastrointestinais ocasionadas em pacientes infectados pelo SARS-CoV-2. Tratou-se de uma revisão bibliográfica, que utilizou artigos científicos disponíveis na íntegra em bases de dados Medical Literature Analysis and Retrieval System Online, Google Acadêmico, Scientific Electronic Library Online, nos meses de abril a outubro de 2021, além de monografias, dissertações, teses e livros. Foram utilizados como descritores as palavras: SARS-CoV-2 e intestino, COVID-19 e intestino, alterações intestinais na COVID-19. Os distúrbios gastrointestinais mais prevalentes são náuseas, vômitos e diarreia e dor abdominal. O papel da microbiota intestinal em influenciar as doenças pulmonares foi bem articulado, devido à existência do eixo intestino-pulmão, a inflamação em um desses órgãos interfere diretamente no perfil inflamatório no outro. Embora ainda não esteja totalmente esclarecido se os sintomas gastrointestinais indicam maior viremia ou um processo fisiopatológico alternativo, observa-se que a presença destes configura um fator de risco para a maior severidade da doença.

The COVID-19 pandemic has spread rapidly around the world, caused by the infection of the new coronavirus (SARS-CoV-2), which emerged in China at the end of 2019. respiratory evidence shows that the disease can present extrapulmonary symptoms, such as those in the gastrointestinal tract. Objective: To describe possible gastrointestinal alterations caused in patients infected by SARS-CoV-2. Methodology: this was a literature review, which used scientific articles available in full in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Academic Google, Scientific Electronic Library Online (SciELO) databases, as well as monographs, dissertations, theses and books. The words used as descriptors were: SARS-CoV-2 and intestine, COVID-19 and intestine, intestinal alterations in COVID-19. Development: The most prevalent gastrointestinal disorders are nausea, vomiting and diarrhea and abdominal pain. The role of the intestinal microbiota in influencing lung diseases was well articulated, due to the existence of the gut- lung axis, inflammation in one of these organs directly interfering with the inflammatory profile in the other. Conclusion: Although it is not yet fully understood whether the gastrointestinal symptoms

La pandemia COVID-19 se ha extendido rápidamente por todo el mundo, causada por la infección del nuevo coronavirus (SARS-CoV-2), que surgió en China a finales de 2019. Las evidencias respiratorias muestran que la enfermedad puede presentar síntomas extrapulmonares, como los del tracto gastrointestinal. Objetivo: Describir las posibles alteraciones gastrointestinales causadas en pacientes infectados por SARS-CoV-2. Metodología: se trató de una revisión bibliográfica, que utilizó artículos científicos disponibles en su totalidad en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE), Academic Google, Scientific Electronic Library Online (SciELO), así como monografías, disertaciones, tesis y libros. Las palabras utilizadas como descriptores fueron: SARS-CoV-2 e intestino, COVID-19 e intestino, alteraciones intestinales en COVID-19. Desarrollo: Las alteraciones gastrointestinales más prevalentes son náuseas, vómitos y diarrea y dolor abdominal. Se articuló bien el papel de la microbiota intestinal en la influencia de las enfermedades pulmonares, debido a la existencia del eje intestino-pulmón, la inflamación en uno de estos órganos interfiere directamente en el perfil inflamatorio del otro. Conclusiones: Aunque aún no se comprenda del todo si los síntomas gastrointestinales indican una mayor viremia o un proceso fisiopatológico alternativo, se observa que su presencia es un factor de riesgo para la mayor gravedad de la enfermedad.

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Objective: To estimate the pooled odds ratio of endometriosis and irritable bowel syndrome, and to estimate the pooled prevalence of irritable bowel syndrome in patients with endometriosis. Data sources: Using Cochrane Library, MEDLINE, Science Direct, ClinicalTrials.gov, Web of Science, and CINAHL, we conducted a systematic literature search through October 2021, using the key terms "endometriosis" and "irritable bowel syndrome." Articles had to be published in English or Spanish. No restriction on geographical location was applied. Methods of study selection: The following eligibility criteria were applied: full-text original articles; human studies; studies that investigated the association between endometriosis and irritable bowel syndrome. Two investigators screened and reviewed the studies. A total of 1,776 studies were identified in 6 separate databases. After screening and applying the eligibility criteria, a total of 17 studies were included for analyses. The meta-analysis of association between endometriosis and irritable bowel syndrome included 11 studies, and the meta-analysis on the prevalence of irritable bowel syndrome in endometriosis included 6 studies. Tabulation integration and results: Overall 96,119 subjects were included in the main meta-analysis (11 studies) for endometriosis and irritable bowel syndrome, with 18,887 endometriosis patients and 77,171 controls. The odds of irritable bowel syndrome were approximately 3 times higher among patients with endometriosis compared with healthy controls (odds ratio 2.97; 95% confidence interval, 2.17 - 4.06). Similar results were obtained after subgroup analyses by endometriosis diagnosis, irritable bowel syndrome diagnostic criteria, and Newcastle-Ottawa Scale scores. Six studies reported prevalence rates of irritable bowel syndrome in women with endometriosis, ranging from 10.6 to 52%. The pooled prevalence of irritable bowel syndrome in women with endometriosis was 23.4% (95% confidence interval, 9.7 - 37.2). Conclusion: Patients with endometriosis have an approximately threefold increased risk of developing irritable bowel syndrome. Development and recent update of Rome criteria has evolved the diagnosis of IBS, potential bias should still be considered as there are no specific tests available for diagnosis. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/displa y_record.php?ID=CRD42018080611], identifier [CRD42018080611].

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The gut microbiota is intrinsically linked to human health; disturbances in microbial homeostasis are implicated in both intestinal and extraintestinal disorders. Probiotics are "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host," and many commercial preparations comprising a diverse range of species are available. While probiotics have been much researched, better understanding of the probiotic effects and applications of species such as Bacillus clausii is warranted. In this narrative literature review, we review the characteristics and mechanisms of action supporting B. clausii as a probiotic and discuss the evidence from clinical studies evaluating B. clausii probiotics for the management of a variety of gastrointestinal disorders and symptoms in children and adults. Finally, we highlight the challenges of future research and the need for more robust and diverse clinical evidence to guide physicians in the clinical application of probiotics for gastrointestinal disorders and other conditions.

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ABSTRACT BACKGROUND: Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms that are not explained by structural or biochemical abnormalities. Their relationship with prematurity has been increasingly studied. OBJECTIVE: To compare the frequency of FGIDs in preterm and term infants and to evaluate whether invasive procedures during the neonatal period in preterm infants are associated with greater likelihood of FGIDs in the first two years of life. DESIGN AND SETTING: Controlled nested cross-sectional study conducted in a Brazilian university hospital. METHODS: This was a controlled nested cross-sectional study on a retrospective cohort of infants born preterm who were compared with infants born at term regarding the presence of FGIDs. Medical consultations were conducted by a single pediatric gastroenterologist to obtain information on the gestational and neonatal periods and on clinical manifestations of the digestive tract. The Rome IV criteria for the diagnosis of FGIDs were used. RESULTS: A total of 197 infants (< 24 months), including 99 preterm and 98 term infants, were studied. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%; P < 0.001). The frequencies of other FGIDs (infant colic, functional constipation, functional diarrhea and infant dyschezia) in preterm infants did not differ from those of term infants (P > 0.05). No relationship was found between invasive procedures during the neonatal period and development of FGIDs in preterm infants. CONCLUSION: Infants born preterm did not have higher frequency of FGIDs in the first two years of life.

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INTRODUCTION AND AIM: Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs. MATERIALS AND METHODS: A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively. RESULTS: Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL. CONCLUSIONS: Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.

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RESUMEN Introducción: Los desórdenes gastrointestinales funcionales pediátricos, comprenden un conjunto de síntomas gastrointestinales crónicos o recurrentes, no explicados por anomalías estructurales o bioquímicas, con interferencia importante en la calidad de vida del niño y su familia. Objetivo: Determinar la prevalencia de los desórdenes gastrointestinales funcionales en adolescentes. Métodos: Estudio observacional, descriptivo de corte transversal, prospectivo con 318 adolescentes pertenecientes a los centros de enseñanza del reparto Camilo Cienfuegos del municipio Habana del Este, en el período comprendido entre marzo 2020 y enero del 2021. Las variables utilizadas fueron edad, sexo, antecedentes personales de dengue, antecedentes familiares de desórdenes gastrointestinales familiares, primogénito, padres separados, hijo único, prematuridad y nacimiento por cesárea. Se utilizó el cuestionario para síntomas digestivos pediátricos, basado en los criterios de Roma IV. Resultados: Un total de 93 estudiantes, para 29,2 % cumplieron los criterios diagnósticos de Roma IV para algún desorden gastrointestinal funcional. Se encontró predominio del sexo femenino (34,3 %) y del grupo de 10-12 años (30 %). El estreñimiento funcional se diagnosticó en 22,7 % de los adolescentes, seguido de la dispepsia funcional en 3,5 %. Conclusiones: Los desórdenes gastrointestinales funcionales son comunes en los adolescentes del estudio. El estreñimiento funcional es el trastorno más frecuente. Los desórdenes gastrointestinales funcionales se presentan de forma significativa en adolescentes del sexo femenino.

ABSTRACT Introduction: Pediatric functional gastrointestinal disorders comprise a set of chronic or recurrent gastrointestinal symptoms, not explained by structural or biochemical abnormalities, with significant interference in the quality of life of the child and his/her family. Objective: Determine the prevalence of functional gastrointestinal disorders in adolescents. Methods: Observational, descriptive cross-sectional, prospective study with 318 adolescents belonging to the educational centers of Camilo Cienfuegos neighborhood, Habana del Este municipality, in the period between March 2020 and January 2021. The variables used were age, sex, personal history of dengue, family history of gastrointestinal disorders, firstborn, separated parents, only child, prematurity and birth by cesarean section. The questionnaire for pediatric digestive symptoms, based on the Rome IV criteria, was used. Results: A total of 93 students (29.2%) met the diagnostic criteria of Rome IV for some functional gastrointestinal disorder. A predominance of the female sex (34.3%) and the group of 10-12 years (30%) was found. Functional constipation was diagnosed in 22.7% of adolescents, followed by functional dyspepsia (3.5%). Conclusions: Functional gastrointestinal disorders are common in the studied adolescents. Functional constipation is the most common disorder. Functional gastrointestinal disorders occur significantly in female adolescents.

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ABSTRACT Objective: To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. Methods: We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI). Results: We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21-25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11-15%) followed by functional dyspepsia (FD) (5%, 95%CI 11-15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2-4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2-26.2%, I2 91.3%). Conclusion: FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.

RESUMO Objetivo: Determinar a prevalência de distúrbios gastrointestinais funcionáis (DGF) em crianças de acordo com os critérios de Roma IV. Métodos: Incluímos coortes e estudos observacionais descritivos, incluindo informações para a prevalência de DGF de acordo com os critérios de Roma IV em crianças de 4 a 18 anos. Pesquisamos nas bases de dados MEDLINE (Ovid), EMBASE, LILACS e CENTRAL de maio de 2016 até os dias atuais. A literatura cinzenta e outras bases de dados também foram consultadas. O risco de viés foi avaliado usando a Declaração STROBE. Os resultados foram relatados em parcelas florestais dos efeitos estimados dos estudos incluídos com um intervalo de confiança de 95% (95%IC). Resultados: Foram incluídos 14 estudos envolvendo um total de 17.427 participantes. Três estudos foram realizados na Europa, dois na América do Norte e nove na América Latina. A maioria dos estudos foi de base escolar (n=14.670, 84,18%), os participantes eram em sua maioria do sexo feminino (55,49%), brancos (51,73%), de 8 a 18 anos (77,64%) e atendidos em escola pública (81,53%). Treze estudos usaram o Questionário de Sintomas Gastrointestinais Pediátricos (QPGS-RIV) para avaliar DGF. Encontramos uma prevalência global de DGF de 23% (95%IC 21-25%, I2 99%). Os principais distúrbios foram constipação funcional (CF) com 12% (95%IC 11-15%) seguido de dispepsia funcional (DF) (5%, 95%IC 11-15%) e síndrome do intestino irritável (SII) (3%, 95%IC 2-4%). A prevalência de DGF foi maior nas Américas, representando 23,67% (95%IC 21, 2-26,2%, I2 91,3%). Conclusão: DGF estão presentes em uma de quatro crianças e adolescentes, representando uma condição comum nessa faixa etária. Os distúrbios centrais foram CF, DF e SII.